van Brakel J, de Muinck Keizer-Schrama S M P F, van Casteren N J, Hazebroek F W, Dohle G R
Department of Urology, Erasmus MC, Rotterdam, The Netherlands.
Department of Paediatrics, Endocrinology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
Andrology. 2015 Sep;3(5):888-94. doi: 10.1111/andr.12070. Epub 2015 Jul 27.
The aim of this study was to report on different anomalies found by physical examination and scrotal ultrasound in men with previously unilateral congenital undescended testes (UDT; N = 50), acquired UDT (N = 49), their contralateral normally descended testis (CNDT) and control testes (N = 53). Acquired UDT significantly more often had a testicular volume being <15 mL than congenital UDT (88% vs. 68%). In the congenital group, significant differences were found between UDT and CNDT for soft consistency (UDT 36% vs. CNDT 14%), epididymal diameter (UDT 7.6 mm vs. CNDT 8.9 mm), testicular volume (UDT 9.8 mL vs. CNDT 13.8 mL), and inhomogeneous parenchyma (UDT 38% vs. CNDT 14%). In the acquired group, significant differences were found between UDT and CNDT for epididymal diameter (UDT 7.5 mm vs. CNDT 8 mm), testicular volume (UDT 9.3 mL vs. CNDT 14.1 mL), testicular volume <15 mL (UDT 88% vs. CNDT 59%), and inhomogeneous parenchyma (UDT 27% vs. CNDT 6%). The following parameters of congenital UDT, acquired UDT, congenital CNDT, and/or acquired CNDT significantly differed compared with controls: soft testicular consistency (congenital UDT 36%, acquired UDT 20%, congenital CNDT 14%, acquired CNDT 12% vs. controls 0%), epididymal diameter (congenital UDT 7.6 mm, acquired UDT 7.5 mm, acquired CNDT 8 mm vs. controls 9.2 mm), testicular volume (congenital UDT 9.8 mL, acquired UDT 9.3 mL, congenital CNDT 13.8 mL, acquired CNDT 14.1 mL vs. control testes 15.8 mL), testicular volume <15 mL (congenital UDT 68%, acquired UDT 88%, congenital CNDT 66% vs. controls 43%), inhomogeneous parenchyma (congenital UDT 38%, acquired UDT 27%, congenital CNDT 14% vs. controls 0%), and testicular microlithiasis (congenital CNDT 24% vs. control testes 8%). Few differences between congenital and acquired unilateral UDT and congenital and acquired CNDT support the hypothesis of a spectrum of maldescended testes containing congenital and acquired UDT instead of them being two different entities. The CNDT also has anomalies albeit less severe than the UDT, indicating that in unilateral UDT both testes are affected.
本研究旨在报告通过体格检查和阴囊超声在既往有单侧先天性隐睾(UDT;n = 50)、后天性UDT(n = 49)、其对侧正常下降睾丸(CNDT)以及对照睾丸(n = 53)的男性中发现的不同异常情况。后天性UDT的睾丸体积<15 mL的情况显著多于先天性UDT(88% 对 68%)。在先天性组中,UDT与CNDT在质地柔软(UDT为36% 对CNDT为14%)、附睾直径(UDT为7.6 mm对CNDT为8.9 mm)、睾丸体积(UDT为9.8 mL对CNDT为13.8 mL)以及实质不均匀(UDT为38% 对CNDT为14%)方面存在显著差异。在后天性组中,UDT与CNDT在附睾直径(UDT为7.5 mm对CNDT为8 mm)、睾丸体积(UDT为9.3 mL对CNDT为14.1 mL)、睾丸体积<15 mL(UDT为88% 对CNDT为59%)以及实质不均匀(UDT为27% 对CNDT为6%)方面存在显著差异。与对照组相比,先天性UDT、后天性UDT、先天性CNDT和/或后天性CNDT的以下参数存在显著差异:睾丸质地柔软(先天性UDT为36%,后天性UDT为20%,先天性CNDT为14%,后天性CNDT为12% 对对照组为0%)、附睾直径(先天性UDT为7.6 mm,后天性UDT为7.5 mm,后天性CNDT为8 mm对对照组为9.2 mm)、睾丸体积(先天性UDT为9.8 mL,后天性UDT为9.3 mL,先天性CNDT为13.8 mL,后天性CNDT为14.1 mL对对照睾丸为15.8 mL)、睾丸体积<15 mL(先天性UDT为68%,后天性UDT为88%,先天性CNDT为66% 对对照组为43%)、实质不均匀(先天性UDT为38%,后天性UDT为27%,先天性CNDT为14% 对对照组为0%)以及睾丸微结石症(先天性CNDT为24% 对对照睾丸为8%)。先天性和后天性单侧UDT以及先天性和后天性CNDT之间的差异较少,支持了隐睾谱包含先天性和后天性UDT而非它们是两个不同实体的假说。CNDT也存在异常,尽管不如UDT严重,这表明在单侧UDT中,两个睾丸均受影响。